executive summary - colorado · executive summary iii. hospital community benefit accountability...

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Executive Summary III. Hospital Community Benefit Accountability Report

This annual report is prepared by the Department of Health Care Policy & Financing (the Department) pursuant to Section 25.5-1-700, C.R.S. (2019). The purpose of this report is to inform stakeholders and policy makers about investments made to improve community health outcomes.

In Fiscal Year (FY) 2019-20, the Department worked with the Colorado Hospital Association to develop rules and additional guidance related to House Bill (HB) 19-1320. The first report from the hospitals was due in FY 2020-21 for activities in the previous fiscal year. Reporting hospitals were required to report on certain community benefit investments and activities.

HB19-1320 requires non-profit tax-exempt general hospitals, Denver Health Medical Center, and University of Colorado Hospital to complete a community health needs assessment every three years and an annual community benefit implementation plan every year1. Each reporting hospital is required to convene a public meeting at least once per year to seek feedback on the hospital’s community benefit activities and implementation plans. These hospitals are required to submit a report to the Department that includes:

• Information on the public meeting held.

• The most recent Community Health Needs Assessment.

• The most recent Community Benefit Implementation Plan.

• The most recent submitted IRS form 990 including Schedule H.

• A description of investments included in Schedule H.

• Expenses included on form 990.

The overall investments across all categories reported totaled $1,221,396,076. Free or reduced-cost health care services totaled $695,804,096. Programs addressing health behaviors or risks and social determinants of health totaled $525,591,980.

The following are maps showing the investments broken out by Division of Insurance region.

1 Long Term Care and Critical Access hospitals are not required to report.

Hospital Community Benefit Accountability Report Executive Summary of 3

Total of all investments reported

Free or reduced-cost health care services

Hospital Community Benefit Accountability Report Executive Summary of 3

Programs addressing health behaviors or risks and social determinants of health

Hospital Community Benefit Accountability

Annual Report

January 15, 2021

III. 2| HCBA Annual Report

Contents

I. Overview ..................................................................................... 3

II. Reporting ..................................................................................... 4

III. Investments .................................................................................. 6

IV. Recommendations ......................................................................... 22

V. Definitions ................................................................................... 23

III. 3 | HCBA Annual Report

I. Overview

House Bill (HB) 19-1320 requires nonprofit tax-exempt general hospitals, Denver

Health Medical Center and University of Colorado Hospital to complete a

community health needs assessment every three years and an annual community

benefit implementation plan every year. Critical access hospitals are not

required to participate, but are encouraged to do so. Each reporting hospital is

required to convene a public meeting at least once per year to seek feedback on

the hospital’s community benefit activities and implementation plans. These

hospitals are required to submit a report to the Department of Health Care

Policy & Financing (the Department) that includes, but is not limited to the

following:

• Information on the public meeting held.

• The most recent Community Health Needs Assessment.

• The most recent Community Benefit Implementation Plan.

• The most recent submitted Internal Revenue Service (IRS) form 990 including

Schedule H.

• A description of investments included in Schedule H.

• Expenses included on form 990.

More information can be found on the Hospital Community Benefit Accountability

webpage.

All submitted reports can be found at Hospital Transparency Webpage.

https://www.colorado.gov/pacific/hcpf/hospital-community-benefit-accountability

https://www.colorado.gov/pacific/hcpf/hospital-community-benefit-accountability

https://www.colorado.gov/pacific/hcpf/hospital-transparency


II. Reporting

Under § 25.5-1-700, C.R.S., the Department is required to submit a report that

includes a summary of the reports submitted from reporting hospitals that

includes the following.

1. The amount that each reporting hospital invested in:

a. Free or reduced-cost health care services addressing community identified

health needs.

b. Programs addressing health behaviors or risks.

c. Programs addressing social determinants of health.

d. All services and programs addressing community identified health needs.

2. A summary of the reporting hospitals’ investments that have been effective in

improving community health outcomes.

3. Any legislative recommendations the Department has for the General

Assembly.

The reports from hospitals were due on July 1, 2020; however, the Department

delayed the due date of the first report to Sept. 1, 2020 due to the novel

coronavirus (COVID-19) emergency. Along with the change in due date, the

Department modified the reporting requirements for the first report in an effort

to minimize the administrative burden on reporting hospitals. Reporting hospitals

were still encouraged to include all the reporting requirements laid out in the

rule under section 8.5002.B to the extent possible.

The Department received 47 submissions, of those, five (5) were critical access

hospitals and one (1) was a new facility with limited information available to

report. The overall investments across all categories reported totaled

$1,221,396,076. Free or reduced-cost health care services totaled $695,804,096.

Programs addressing health behaviors or risks and social determinants of health

totaled $525,591,980. During the submission process, several reporting hospitals

expressed concerns with how the investment categories were requested to be

reported. For the purposes of this report, the Department has combined the

amounts for programs addressing health behaviors or risks and programs

addressing social determinants of health.

https://leg.colorado.gov/bills/hb19-1320

https://www.sos.state.co.us/CCR/DisplayRule.do?action=ruleinfo&ruleId=3327&deptID=7&agencyID=69&deptName=Department%20of%20Health%20Care%20Policy%20and%20Financing&agencyName=Medical%20Services%20Board%20(Volume%208;%20Medical%20Assistance,%20Children%27s%20Health%20Plan)&seriesNum=10%20CCR%202505-10%208.5000


Table 1 – Reporting Hospitals

Provider County Hospital System

Avista Adventist Hospital Boulder Centura Health

Boulder Community Health Boulder

Castle Rock Adventist Hospital Douglas Centura Health

Children's Hospital Colorado Adams

Community Hospital Mesa

Delta County Memorial Hospital Delta

Denver Health and Hospital Authority Denver

East Morgan County Hospital Morgan Banner Health

Estes Park Medical Center Larimer

Fort Collins Medical Center Larimer Banner Health

Good Samaritan Medical Center Boulder SCL Health

Littleton Adventist Hospital Arapahoe Centura Health

Longmont United Hospital Boulder Centura Health

Lutheran Medical Center Jefferson SCL Health

McKee Medical Center Larimer Banner Health

Mercy Regional Medical Center La Plata Centura Health

Montrose Memorial Hospital Montrose

National Jewish Health Denver

North Colorado Medical Center Weld Banner Health

Parker Adventist Hospital Douglas Centura Health

Parkview Medical Center Pueblo

Penrose-St Francis Health Services El Paso Centura Health

Platte Valley Medical Center Adams SCL Health

Porter Adventist Hospital Denver Centura Health

Rio Grande Hospital Rio Grande

Saint Joseph Hospital Denver SCL Health

San Luis Valley Health Alamosa

St Anthony Hospital Jefferson Centura Health

St Anthony Hospital North Health Campus Broomfield Centura Health

St Anthony Summit Medical Campus Summit Centura Health

St Mary Corwin Hospital Pueblo Centura Health

St Mary's Regional Medical Center Mesa SCL Health

St Thomas More Hospital Fremont Centura Health

St Vincent General Hospital District Lake

Sterling Regional Medical Center Logan Banner Health

UCHealth Broomfield Hospital Jefferson UCHealth

UCHealth Grandview Hospital El Paso UCHealth

UCHealth Greeley Hospital Weld UCHealth

UCHealth Highlands Ranch Hospital Douglas UCHealth

UCHealth Longs Peak Hospital Weld UCHealth

UCHealth Medical Center of the Rockies Larimer UCHealth

UCHealth Memorial Hospital El Paso UCHealth

UCHealth Poudre Valley Hospital Larimer UCHealth

UCHealth University of Colorado Hospital Adams UCHealth

UCHealth Yampa Valley Medical Center Routt UCHealth

Vail Health Eagle

Valley View Hospital Garfield


III. Investments

Avista Adventist Hospital

• Engage with community to understand community health needs and how to

best address them in partnership with community organizations.

• Increase access to care through care coordination system.

• Provide transportation services for patients leaving the hospital.

• Childbirth training and education classes for pregnant women.

Boulder Community Health

• Provide athletic trainers to school district.

• Grants to individuals for prescription medication, food, housing, etc.

• Community health education lectures and program series to directly address

health conditions, behaviors and risks.

• Provide educational programs for new parents.

• Provide support to local partner nonprofit organizations that directly

address social determinants of health.

Castle Rock Adventist Hospital


best address them in partnership.

• Screening for social needs and referral to community-based resources.

• Campaign to decrease mental health stigma.

• Engage individuals in weight loss through healthy eating and active living.

Children's Hospital Colorado

• Provide asthma home visits.

• Provide education and outreach coordinators work with children and

families to provide asthma education.

• Initiative to address the social isolation and toxic stress stemming from

institutional racism.

• Provide opportunity for oral health promotion and improved access to oral

health services for children in the community.

• Provide patient families with community-based services to meet non-

medical health needs such as housing, benefits and food.


• Increase access to timely, quality, and affordable food for kids and their

families.

Community Hospital

• Recruit additional primary care providers to the area.

• Educate residents on when and how to utilize appropriate healthcare

services.

• Promote lifestyle‐modification initiatives to improve the health of teens and

young adults.

• Add a cardiac catheterization lab to the lines of services offered.

Delta County Memorial Hospital

• All Points Transit helps meet the transportation needs of Montrose, Delta

and San Miguel counties.

• Dial-a-Ride provides much needed transportation to seniors and other higher

risk populations for medical visits and shopping

Denver Health and Hospital Authority

• Provide safe detoxification for public inebriates.

• Provide assessment, education, motivational counseling and residential

treatment.

• Daily tobacco cession clinics.

• Guide customers through a health care program screening process.

• Health promotion and obesity prevention.

• Program that serves underrepresented youth that are challenged with

academic achievement or have other significant risk factors.

• 24-hour nurse line.

• Substance treatment program that specializes in working with adolescents.

East Morgan County Hospital

• Community blood drives.

• Provide education to residents which allow for early intervention and health

management.

• Educate young people by taking the fear out of hospitals and exposure to

the myriad of healthcare careers and opportunities.


• Provide community food and nutrition education classes.

• Provide chronic illness support groups.

• Provide enrollment assistance to the vulnerable and underserved.

• Investments that support activities that encourage citizens to be

community-mined, engaged and healthy.

Estes Park Medical Center

• Rural Estes Alliance for Community Health provides and supports community

wide initiatives and education designed to improve the overall health and

well-being of those in the Estes Valley.

Fort Collins Medical Center


management.


• Contribution to local breast cancer organization that supports quality of life

initiatives.

• Provide post-discharge services to the vulnerable and underserved.

• Elderly day care.

Good Samaritan Medical Center

• Participation in community coalitions and other collaborative efforts.

• Provide health and wellness education classes, stroke support group, health

fairs, and trauma injury prevention outreach and workshops.

• Support of community-based organizations that address areas such as access

to health services, medical education, free clinic services or social supports.

Littleton Adventist Hospital

• Screening of people with social needs and referral to community-based

resources.

• Use evidence-based messaging to decrease stigma associated with mental

health.

• Provide of Mental Health First Aid classes to community.

Longmont United Hospital


• Support health care services within the community through local Community

Health Center.

• Provide health education to the community regarding obesity prevention.

• Partner with coalition providing mental health services and stigma reduction

activities.

• Provide a location for a community farmer's market.

Lutheran Medical Center

• Provide community health and wellness education, maternal addiction

services, falls prevention, trauma education and tobacco cessation.

• Support community-based organizations that address areas such as access to

health services, medical education, free clinic services or social supports.

• Services supporting cardiac rehab, dialysis, pulmonary rehab,

obstetric/newborn, neonatal intensive care unit, infusion center and West

Pines Psychiatric.

McKee Medical Center


management.


• Elderly day care.

• Assist patients, families and caregivers with end-of-life issues and advanced

care planning.


Mercy Regional Medical Center

• Increase the capacity of food pantry to offer healthy foods.

• Provide healthy eating and active living education at community events and

through classes available to community.

• Support of Community Health Center to provide health care to

uninsured/underinsured.

• Provide no-cost physical exams to survivors of sexual assault and connects

them to follow-up community resources.

Montrose Memorial Hospital


• Provide education for women's health and family planning, healthy lifestyles

and prevention of heart disease, diabetes and stroke.

• Provide transportation to and from hospital and physician appointments for

elderly and low income.

• Physician recruitment to bring jobs and necessary medical support to the

community.

National Jewish Health

• Provide education programs, classes, and support groups for specialty care

illnesses and diseases.

• Provide free K-8 school for chronically ill children; participation in

community coalition.

• Provide free lung testing programs.

• Provide inner city asthma program.

• Provide free asthma care and teaching program in lower income

communities.

• Conduct a study to collect and interpret air quality data.

North Colorado Medical Center



• Provide donations to community building organizations.


management.

Parker Adventist Hospital


health.

• Provide Mental Health First Aid to community members through community-

based organizations.

• Weigh and Win program provided at no cost to community to support

evidence-based healthy weight management.

Parkview Medical Center

• Hiring a Community Risk Reduction Behavioral Health Specialist.


• Mobile Nurse program providing community-based health education, health

screenings and immunizations.

• Software investment, Pieces Technology, to identify patients with adverse

social determinants of health and to connect patients with the appropriate

resources/support.

Penrose-St Francis Health Services

• Provide cancer screening and health education to Latino populations.

• Hold events to promote healthy eating and active living to prevent and

reduce obesity.

• Engage with community partners to provide mental health support for youth

in the community.

• Provide healthy meals for seniors to support weight management and

obesity prevention/reduction.

• Provide free health screenings for community members.

Platte Valley Medical Center

• Provide nutritional classes, diabetes management classes, wound care

classes, and mental health first aid trainings.

• Activities that strengthen prevention, self-help, language translation, health

literacy and social supports for low-income and vulnerable population

segments.

• Participate in community coalitions and other collaborative efforts.

• Nutrition Department Community Outreach and education.

• Support community organizations serving a broad spectrum of needs.

Porter Adventist Hospital

• Provide prescriptions to patients with income barriers to treatment of their

health diagnoses.

• Provide mental health support groups to community members.

• Provide free transportation to patients without transportation.

• Increase access to healthy foods and physical activity through gardening

within community.

• Increase access to oral health care for children.



health.

Saint Joseph Hospital

• Provide health education classes.



segments.

• Participate in community coalitions and other collaborative efforts with the

community.

• Support other community-based organizations that address areas such as -

access to health services, medical education, free clinic services or social

supports.

• Housing stabilization project.

• Conduct a monthly forum for nonprofit health and human service

community agencies and partners to share information.

San Luis Valley Health

• Hold various community services such as food banks, VA support, adopt a

family, health fairs and support groups that address wellness, child

development and substance abuse.

St Anthony Hospital

• Partner with Senior Resource Center for fall prevention and appropriate

medical care among seniors.

• Provide a Diabetes Prevention Program.


health.



• Provide Nurse Family Partnership program for first time, low income

mothers.

St Anthony Hospital North Health Campus


• Provide free integrative healing services to community members and

patients.

• Provide transportation to patients without transportation.


health.



• Support for community mental health center providing mental health and

drug treatment services to the community.

St Anthony Summit Medical Campus


best address them in partnership.

• Evidence-based injury prevention approaches.

• Support local nonprofit organizations providing evidence-based programs to

reduce stigma associated with mental health.

• Provide no-cost physical exams to survivors of sexual assault and connects

them to follow-up community resources.

St Mary Corwin Hospital

• Engage with organization to understand community needs.

• Provide free health screenings for community.

• Increase capacity of food pantry.

• Drug take back program.

St Mary's Regional Medical Center

• Provide various support groups.

• Provide Mental Health First Aid.

• Injury Prevention & Outreach.



segments.

• Participation in community coalitions and other collaborative efforts with

the community.


• Support community-based organizations that address areas such as - access

to health services, medical education, free clinic services or social supports.

St Thomas More Hospital

• Provide free screenings to all students.

• Provide grief support.

St Vincent General Hospital District

• Increase the counties access to qualified health care through the Emergency

Department.

• Engage with visiting physicians and physician’s assistant to provide cardiac

care and orthopedic services.

• Contract with a Health Insurance Navigator to help residents apply for

commercial insurance and state Medicaid benefits.

Sterling Regional Medical Center

• Conduct community blood drives and screenings.

• Provide access to education and assistance on wellness topic/issues which

allow for early prevention and diagnosis and improve the overall health.


• Palliative care program provides compassionate, comprehensive and

interdisciplinary care that reduces suffering and optimizes quality of life.

UCHealth Broomfield Hospital

• Support for the development of new programs and recruitment of primary

care and specialty care providers.

• Support new program that conducts research into the genetic differences

among people that influence health, disease and treatments.

• Financial contributions to support other non-profit and community-based

organizations that promote the health and well-being of the community.

UCHealth Grandview Hospital







organizations.

UCHealth Highlands Ranch Hospital







UCHealth Longs Peak Hospital







• No-cost service providing mothers the opportunity to meet with a certified

lactation consultant.

• Community health program that serves people ages 50 and above offering

no-cost Medicare counseling, advance care planning, fall prevention.

UCHealth Medical Center of the Rockies






organizations.

• School and community-based program educating on how to live heart

healthy lifestyles.


• Program that provides care, counseling, and referral services to assault

victims.

• Support community organizations dedicated to prevention and treatment of

specific health needs.

UCHealth Memorial Hospital





• HealthLink nurse advice line is free to all community members throughout

the state of Colorado.


organizations.

• Provide education and training programs for healthcare professionals.

• Partner with various organization to provide access to inpatient and

behavioral health services.

• Financial contributions to support community organizations dedicated to the

prevention and treatment of specific health needs.

UCHealth Poudre Valley Hospital




• Program that provides visits for newborn infants and postpartum mothers.

• Partner with elementary schools to provide health education.



• Support the Special Operation Response Team.

• Injury prevention programs for older adults.

• Support community organizations dedicated to prevention and treatment of

specific health needs.


organizations.


• Provide educational programs to increase awareness and education around

health needs.

UCHealth University of Colorado Hospital





• Financial contributions to support other nonprofit and community-based

organizations.


• Financial contributions to support community organizations dedicated to the

prevention and treatment of specific health needs.

• Provide a series of educational programs designed to increase awareness

and education around health needs in our communities.

UCHealth Yampa Valley Medical Center






organizations.

• Support agency operations providing post discharge care coordination.

• Provide education programs to increase awareness and education around

health needs.

• Provide nurse consultations at no cost to assess symptoms and provide

advice.

Vail Health

• Provide support group for new moms.

• Hold a community cooking class.

• Eat-Chat-Parent series, with topics including Building Resiliency and Self

Esteem in our Kids, Addressing Technology Misuse, Teen Substance Abuse

and the Role of Toxic Stress.


• Collaboration with multiple community partners to improve inter-agency

patient care.

• Various cancer related support groups, health programs, classes, and

counseling.

• Foster the retention of new graduate nurses by creating a support system

for success.

• Participate in high school internship program.

• Provide medical care at community events.

Valley View Hospital

• Partner with local non-profit to support the nutritional needs of patients in

the community.

• Invest in the Roaring Fork School District by providing a majority of the staff

salaries for the athletic trainers.

• Health promotion and information provided through media to educate the

public about health issues.

• Support local nonprofits that specialize in mental health, education, and

community wellness.

• Member of the Valley Health Alliance focused on improving access to quality

care, population health management and reduce waste in the healthcare

system.

Table 2 – Investment Amounts

Provider Free or Discounted

Services Health Behaviors and Social

Determinants of Health Total

Avista Adventist Hospital $5,563,044 $582,632 $6,145,676

Boulder Community Health $53,073,548 $870,407 $53,943,955

Castle Rock Adventist Hospital $11,183,493 $11,650 $11,195,143

Children's Hospital Colorado $3,462,481 $19,649,562 $23,112,043

Community Hospital $5,919,192 $224,400 $6,143,592

Delta County Memorial Hospital $581,162 $9,500 $590,662

Denver Health and Hospital Authority

$204,091,419 $660,934 $204,752,353

East Morgan County Hospital $1,030,550 $13,825 $1,044,375

Fort Collins Medical Center $9,241,836 $58,506 $9,300,342

Good Samaritan Medical Center $1,524,686 $3,281,717 $4,806,403

Littleton Adventist Hospital $17,495,678 $344,503 $17,840,181

Longmont United Hospital $16,040,266 $19,526 $16,059,792

Lutheran Medical Center $2,973,478 $9,209,757 $12,183,235

McKee Medical Center $8,014,370 $277,422 $8,291,792


Provider Free or Discounted

Services Health Behaviors and Social

Determinants of Health Total

Mercy Regional Medical Center $13,236,933 $774,505 $14,011,438

Montrose Memorial Hospital $8,104,300 $1,010,674 $9,114,974

National Jewish Health $72,218 $31,591,272 $31,663,490

North Colorado Medical Center $44,262,705 $565,791 $44,828,496

Parker Adventist Hospital $20,405,250 $62,240 $20,467,490

Parkview Medical Center $4,064,565 $259,298 $4,323,863

Penrose-St Francis Health Services

$52,498,799 $809,353 $53,308,152

Platte Valley Medical Center $2,369,089 $4,869,788 $7,238,877

Porter Adventist Hospital $38,275,209 $238,684 $38,513,893

Saint Joseph Hospital $10,742,146 $22,251,726 $32,993,872

San Luis Valley Health $752,632 $150,672 $903,304

St Anthony Hospital $58,700,291 $605,032 $59,305,323

St Anthony Hospital North Health Campus

$27,757,001 $82,084 $27,839,085

St Anthony Summit Medical Campus

$5,563,044 $513,412 $6,076,456

St Mary Corwin Hospital $15,512,700 $165,955 $15,678,655

St Mary's Regional Medical Center

$6,116,852 $14,216,751 $20,333,603

St Thomas More Hospital $1,003,388 $8,296 $1,011,684

St Vincent General Hospital District

$181,872 $10,907 $192,779

Sterling Regional Medical Center $813,647 $7,800 $821,447

UCHealth Broomfield Hospital $326,947 $1,841,359 $2,168,306

UCHealth Grandview Hospital $118,951 $514,036 $632,987

UCHealth Highlands Ranch Hospital

$16 $119,070 $119,086

UCHealth Longs Peak Hospital $396,769 $21,233,134 $21,629,903

UCHealth Medical Center of the Rockies

$2,088,195 $82,519,663 $84,607,858

UCHealth Memorial Hospital $1,698,343 $86,685,417 $88,383,760

UCHealth Poudre Valley Hospital $2,421,701 $50,740,540 $53,162,241

UCHealth University of Colorado Hospital

$1,866,764 $149,745,703 $151,612,467

UCHealth Yampa Valley Medical Center

$658,550 $3,631,595 $4,290,145

Vail Health $19,821,554 $13,997,818 $33,819,372

Valley View Hospital $15,778,462 $1,155,064 $16,933,526

Totals $695,804,096 $525,591,980 $1,221,396,076

The overall investments across all categories reported totaled $1,221,396,076.

Free or reduced-cost health care services represents 57% of the total and

programs addressing health behaviors or risks and social determinants of health

represents 43% of the total.


Graph 1 – Total of all investments report

Graph 2 – Total of all investments reported by Division of Insurance region


Graph 3 – Free or reduced-cost health care services by Division of Insurance region

Graph 4 – Programs addressing health behaviors or risks and social determinants of

health by Division of Insurance region


IV. Recommendations

The Department is making the following recommendations to the General

Assembly:

1. Hospitals experienced challenges to report their community benefit

expenditures in the state’s categories as those do not crosswalk to the

federal categories exactly. While the Department will continue to provide

guidance to hospitals, the General Assembly may wish to re-evaluate the

categories that are being reported to align with federal definitions.

2. The current law does not require a minimum expenditure in any category or

set priorities. The General Assembly may wish to establish community benefit

priorities in future legislation.

3. Because there is currently no consistent national standard on what

community benefit entails, the General Assembly may wish to include

information on what other States have done or are doing as part of their

community benefit process and oversight.

4. With no consistent national standard and no requirement on a minimum

expenditure for community benefit, the General Assembly may wish to

include additional information from the Schedule H as well as an audit on the

tax benefit in order to have a better understanding of the hospitals tax

exemption benefit and community benefit spending.


V. Definitions

Community - the community that a hospital has defined as the community that

it serves pursuant to 26 CFR § 1.501(r)-(b)(3).

Community Benefit Implementation Plan - a plan that satisfies the

requirements of an implementation strategy as described in 26 CFR § 1.501(r)-

3(c).

Community Health Center - a federally qualified health center as defined in 42

U.S.C. sec. 1395x(aa)(4) or a rural health clinic as defined in 42 U.S.C. sec.

1395x (aa)(2).

Community Health Needs Assessment - a community health needs assessment

that satisfies the requirements of 26 CFR § 1.501(r)-3(b).

Community Identified Health Need - a health need of a Community that is

identified in a Community Health Needs Assessment.

Financial assistance policy (FAP) - a written policy that meets the requirements

described in § 1.501(r)– 4(b).

Free or Discounted Health Care Services - health care services provided by the

hospital to persons who meet the hospital’s criteria for financial assistance and

are unable to pay for all or a portion of the services, or physical or behavioral

health care services funded by the hospital but provided without charge to

patients by other organizations in the Community. Free or Discounted Health

Care Services does not include the following:

1. Services reimbursed through the Colorado Indigent Care Program (CICP),

2. Bad debt or uncollectable amounts owed that the hospital recorded as

revenue but wrote off due to a patient’s failure to pay, or the cost of

providing care to such patients,

3. The difference between the cost of care provided under Medicaid or other

means-tested government programs or under Medicare and the revenue

derived therefrom,

4. Self-pay or prompt pay discounts, or


5. Contractual adjustments with any third-party payers.

Health System - a larger corporation or organizational structure that owns,

contains, or operates more than one hospital.

Programs that Address Health Behaviors or Risk - programs funded by the

hospital and provided by the hospital or other Community organizations that

provide education, mentorship, or other supports that help people make or

maintain healthy life choices or manage chronic disease, including addiction

prevention and treatment programs, suicide prevention programs and mental

health treatment, programs to prevent tobacco use, disease management

programs, nutrition education programs, programs that support maternal health,

including screening, referral and treatment for perinatal and postpartum

depression and anxiety, and healthy birth outcomes, and programs that help

seniors and people with disabilities live as independently as possible in the

Community.

Programs that Address the Social Determinants of Health - funding or in-kind

programs or services that improve social, economic, and environmental

conditions that impact health in the Community. Social and economic conditions

that impact health include education; employment; income; family and social

support; and Community safety. Environmental conditions that impact health

include air and water quality, housing, and transit. Programs that Address the

Social Determinants of Health include but are not limited to the following:

1. Job training programs,

2. Support for early childhood and elementary, middle, junior-high, and high

school education,

3. Programs that increase access to nutritious food and safe housing,

4. Medical Legal Partnerships, and

5. Community-building activities that could be included in Part II of Schedule

H of the Form 990.

Reporting Hospital

1. A hospital licensed as a general hospital pursuant to Part 1 of Article 3 of

Title 25 of the Colorado Revised Statutes and exempt from Federal


taxation pursuant to Section 501(c)(3) of the Federal Internal Revenue

code, but not including a general hospital that is federally certified or

undergoing federal certification as a long-term care hospital pursuant to

42 CFR § 412.23(e) or that is federally certified or undergoing federal

certification as a critical access hospital pursuant to 42 CFR § 485 Subpart

F,

2. A hospital established pursuant to § 25-29-103 C.R.S., or

3. A hospital established pursuant to § 23-21-503 C.R.S.

Safety Net Clinic - a Community clinic licensed or certified by the Department of

Public Health and Environment pursuant to Section § 25-1.5-103 (1)(a)(I) or

(1)(a)(II), C.R.S.

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